Endo/Repro Anatomy

Question 1

Ilium

Answer 1

Upper 2/5th of acetabulum - articulates posteriorly with sacrum

Question 2

Ischium

Answer 2

Posterior-Inferior 2/5 of acetabulum - superior and inferior rams form the obturator foramen

Question 3

Pubis

Answer 3

Superior rams forms anterior 1/5th of acetabulum

Question 4

Describe the pubic symphysis joint

Answer 4

Fibrocartilaginous disc linking the pubis bones, only site of movement especially during pregnancy

Question 5

Describe the sacroiliac joints

Answer 5

Synovial joints, reinforced by anterior, posterior, and interosseous SI ligaments, additional reinforcement by sacrotuberous lig
Movement primarily gliding but can be rotary, interosseous and sacrotuberous resist rotary movement

Question 6

Path of sacrotuberous ligament

Answer 6

From sacrum to the pubic tuberosity

Question 7

Which ligaments resist rotary movement of the pelvis?

Answer 7

Interosseous and sacrotuberous

Question 8

Describe the terminal line and what lies above/below

Answer 8

Runs along the iliopubic eminence (pubic and iliac bones) completed posteriorly by rounded angle btw base and pelvic surface of the sacrum
False (major) lies above the line
True (minor) lies below the line
Pelvic inlet runs in the plane of the line
Pelvic outlet is the irregular lower border

Question 9

Describe the pelvis in the normal erect position

Answer 9

Tips 50-60 degrees from the horizontal
Base of sacrum is 4 in higher than the symphysis
ASIS and symphysis pubis lie in about the same line

Question 10

Compare the female pelvis to the male pelvis

Answer 10

Shallower major pelvis with everted anterior crests
Shallower wider minor pelvis with greater diameter
Everted sciatic tubers
Broader sacrum with less curve
Superior aperture more oval
Subpubic angle greater (angle formed by pubic symphysis

Question 11

Android

Answer 11

Most common male - heart shaped pelvic inlet (30% females)

Question 12

Anthropoid

Answer 12

2nd most common male - exaggerated anterior/posterior inlet (20% female)

Question 13

Gynecoid

Answer 13

Most common female - slightly oval inlet (47% female)

Question 14

Platypelloid

Answer 14

Least common both sexes - transverse inlet diameter (3% female)

Question 15

The usual site of pelvic constriction is where?

Answer 15

Superior

Question 16

True conjugate

Answer 16

Sacrovertebral angle to superior margin of symphysis

Question 17

Diagonal conjugate

Answer 17

Sacroverterbral angle to inferior margin of symphysis

Question 18

Transverse (Superior)

Answer 18

Greatest width of superior aperature

Question 19

Oblique

Answer 19

Sacroiliiac articulation of one side to iliopectineal eminence of the other side

Question 20

Transverse (Inferior)

Answer 20

Btw inner surfaces of ischial tuberosity

Question 21

Ant sagittal

Answer 21

Transverse diameter to symphysis

Question 22

Post sagittal

Answer 22

Transverse diameter to sacrococcygeal junction

Question 23

Obturator internus m.

Answer 23

O: inner surface of obturator membrane and surrounding bony rim
I: greater trochanter
A: External rotation of thigh
In: N. to obturator internus
Leaves pelvis as tendon passing around margin of lesser sciatic notch - covered by heavy obturator fascia from which levator ahi arises

Question 24

Piriformis m.

Answer 24

O: sacrum
I: greater trochanter
A: external rotation and abduction of thigh
Leaves pelvis passing thought greater sciatic foramen

Question 25

The pelvic diaphragm is made up of what 2 muscles?

Answer 25

Levator anim. and coccygeus m.

Question 26

Levator ani - pubococcygeus m.

Answer 26

``` O: pubis I: coccyx and anococcygeal lig A: supports pelvic visera In: perineal branches of S3, S4 Anterior to rectum the right and left portions are separated - separation bridged by connective tissue, urethra of both sexes passes through this opening ```

Question 27

Levator ani - iliococcygeus m.

Answer 27

O: Arcus tendineus (obt fascia btw pubis and spine) I:coccyx and anococcygeal lig A: supports pelvic viscera In: perineal branches of S3, S4

Question 28

Levator ani - puborectalis m.

Answer 28

O: pubis I: puborectalis from opposite side on posterior side of rectum A: supports pelvic visera, maintains anorectal junction In: perineal branches of S3, S4 Lying along upper surface of pubococcygeus m.

Question 29

Coccygeus m.

Answer 29

``` O: ischial spine, sacrotub lig I: coccyx and lower part of sacrum A: supports pelvic visera In: S4, S5 ventral rami Most posterior m. of pelvic diaphragm ```

Question 30

Urinary tract elements

Answer 30

Anteriorly placed structures: Pelvic portion of ureter Urinary bladder

Question 31

GI tract elements

Answer 31

Posteriorly placed structures: Rectum Anal canal

Question 32

Reproductive organs

Answer 32

Lie btw urinary tract and GI elements Male - pelvic vas deferens, seminal vesicles, prostate gland Female - vagina, uterus, uterine tubes, ovaries

Question 33

Inner walls and floor of pelvis

Answer 33

Consists of membranous lining and loose connective tissue surrounding pelvic contents Fills space btw peritoneum and muscles

Question 34

Peritoneum of pelvis

Answer 34

Does not contact floor and walls of pelvis but is draped over superior aspects of structures in pelvis, forming distinct pouches and folds

Question 35

Rectovesical pouch

Answer 35

Male btw rectum and bladder

Question 36

Rectouterine pouch

Answer 36

Female btw rectum and uterus

Question 37

Vesicouterine pouch

Answer 37

Female btw superior aspect of urinary bladder and the uterus

Question 38

Broad ligament

Answer 38

Found only in females - reaches laterally across pelvis, folded over uterus, formed during formation of uterus and vagina from paramesonephric ducts

Question 39

Boundaries of the perineum

Answer 39

Ant: pubis Lateal: ischiopubic rami and ischial tuberosities Post: coccyx and caudal sacrum Post lat: sacrotuberous lig Sup: separated from pelvic cavity by pelvic diaphragm

Question 40

Urogenital diaphragm

Answer 40

Stretches ant btw 2 ischiopubic rami creating urogenital and anal regions

Question 41

Perineum

Answer 41

Anatomically area btw coccyx and pubis, often used to refer to central tendon of females

Question 42

Anal triangle boundaries

Answer 42

Ant: post edge of urogenital diaphragm Post: boundaries of perineum Lat: ischippubic rami and obt int m. below the arcs tendineus Sup: roof formed by inf aspect of pelvic diaphragm Inf: Skin and superficial fascia of perineum

Question 43

Ischioanal fossa - boundaries

Answer 43

Filled with adipose tissue